Classification Tree Diagram of Mash et al for Evaluating a Child with Failure to Thrive for Medical Abuse

Description

Mash et al developed a classification tree for evaluating a child who is showing a failure to thrive. This can help to distinguish true failure to thrive from medical (non-physical) abuse and neglect. The authors are from the Cleveland Clinic and Children's Hospital Cleveland.

Patient selection: child < 5 years of age with failure to thrive

Parameters:

(1) number of organ systems involved

(2) serious congenital anomaly and/or confirmed genetic disorder

(3) number of reported allergies

(4) response to referral to a feeding team

Number of Organ Systems Involved	Response to Referral	Congenital or Genetic Disorder	Number of Allergies	Percent Medical Abuse (Risk)
0 to 4	accept	NA	NA	0% (low)
0 to 4	refuse	NA	NA	50% (intermediate)
5 or more	NA	yes	0 to 4	0% (low)
5 or more	NA	yes	5 or more	75% (high)
5 or more	NA	no	NA	93% (high)

Performance in study population:

• The tree was 100% sensitive and 96% specific (for low vs intermediate or high risk.

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Classification Tree Diagram of Mash et al for Evaluating a Child with Failure to Thrive for Medical Abuse

Description

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